Renoxtin

Indications

Oxaliplatin is a chemotherapy medicine used in adults, usually together with Fluorouracil and Folinic Acid (Leucovorin) or with Capecitabine, for:

• colon cancer that has spread to nearby lymph nodes (stage III), after the tumour has been removed by surgery, to lower the chance of it coming back;
• advanced or spread (metastatic) cancer of the colon or rectum.

Cancer specialists may also use it for some other cancers of the digestive system.

How It Works

Oxaliplatin is a platinum-based chemotherapy medicine. It binds to the DNA inside cancer cells and forms links that stop the DNA from being copied and repaired. As a result, the cancer cells cannot divide and they die.

Dosage and Administration

Oxaliplatin is a hospital medicine. It is given as a drip (infusion) into a vein by a doctor or nurse, usually over 2 to 6 hours, typically once every 2 or 3 weeks.

The dose is calculated from body surface area (height and weight), as prescribed by the cancer specialist. The number of cycles depends on the treatment plan. Blood tests are done before each cycle, and the dose may be delayed or lowered depending on blood counts and side effects, especially nerve symptoms.

Anti-sickness medicines are usually given before each infusion.

Interactions

• Other medicines that can damage nerves may make nerve side effects worse.
• Medicines that affect heart rhythm (QT prolongation), such as some antibiotics, antipsychotics and anti-sickness medicines, need caution.
• Warfarin effects may increase during treatment with Fluorouracil-based regimens; INR should be checked.
• Live vaccines should not be given during treatment.

Tell the cancer team about all medicines, herbal products and supplements you use.

Contraindications

Oxaliplatin should not be used if you:

• are allergic to Oxaliplatin or other platinum medicines;
• have very low white blood cell or platelet counts before starting a cycle;
• already have nerve damage (numbness or tingling) that affects your daily activities;
• have severe kidney disease;
• are pregnant or breastfeeding.

Side Effects

Common: tingling or numbness in the hands, feet or around the mouth, often brought on by cold; jaw or throat discomfort when drinking cold liquids; nausea, vomiting, diarrhoea, tiredness, mouth sores, loss of appetite and low blood counts.

Get urgent medical help if you have:

• itching, rash, flushing, chest tightness, swelling or difficulty breathing during or after the infusion (allergic reaction);
• a temperature of 38°C or higher, chills or other signs of infection;
• a feeling that you cannot breathe or swallow, or tightness in the throat;
• severe or ongoing diarrhoea or vomiting;
• unusual bleeding or bruising;
• new cough or shortness of breath;
• headache, confusion, seizures or changes in vision;
• a fast or irregular heartbeat or fainting.

Pregnancy and Lactation

Oxaliplatin can harm an unborn baby and must not be used during pregnancy. Women and men should use effective contraception during treatment and for the period the specialist advises after the last dose. Do not breastfeed during treatment. Oxaliplatin may affect fertility; ask about options before starting.

Precautions and Warnings

• For a few days after each infusion, avoid cold drinks, ice, and touching cold objects; wear gloves and a scarf in cold weather.
• Tell your doctor about any numbness, tingling or difficulty with buttons or writing; the dose may need to change.
• Regular blood tests check blood counts, kidney and liver function.
• Tell your doctor if you have heart rhythm problems, kidney disease or a history of allergy to platinum medicines.
• Avoid contact with people who have infections, and wash hands often.

Overdose

Overdose is managed in hospital. It may cause severe low blood counts, severe nerve damage, vomiting and diarrhoea. There is no specific antidote; supportive care is given.

Therapeutic Class

Anticancer medicine; platinum-based chemotherapy (alkylating-like agent).

Storage

Stored by the hospital pharmacy as directed on the product label, usually below 25°C, in the outer carton to protect from light. Do not freeze. Keep out of the reach of children.